How to survive the downward spiral of anxiety

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Population studies highlight a surge in the use of antidepressants and anti-anxiety medication in women, while clinicians see increasingly complex presentations of stress, anxiety and depression in female patients.

Societal patterns and trends over the past decade – like the early onset of puberty in girls, easy access to the internet, precocious sexual awareness or experimentation, reconstituted and single parent families – affect vulnerable groups like women and children.

The Epidemiological Catchment Areas Study found that generalised anxiety is more likely to present in women and in those with childhood fears or marital or sexual disturbances. Panic attacks are twice as common in women, while hormonal changes during puberty, menstruation, pregnancy, childbirth and menopause cause bloating, weight gain, stress, anxiety and mood disturbances.

One study associated psychiatric disturbances with a multifactorial genesis (incorporating a cultural context) in women. In men, on the other hand, it was linked directly to workplace bullying. Certain societal expectations haunt women throughout their lives, even in an evolving and increasingly cosmopolitan society like ours. Achieving work-life balance after motherhood remains a challenge. There is documented evidence of higher rates of suicidal ideation and attempts of suicide in the lesbian population.

Women respond differently to stress and are significantly more likely to eat more. This leads to weight gain and body image problems that further heighten stress. Women reportedly talk more to family and friends to cope with job-related stress. Hence, their self-worth may hinge on the response of their support network.

Telltale signs of stress and anxiety include worries or fears that are out of proportion, avoidance of the feared situation and lack of control. Bodily symptoms (fluttering heart, queasy tummy, shaking hands, sweating, recurrent headaches) can confuse matters by mimicking a physical illness. Frustration and anger may affect personal relationships, initiating a vicious downward spiral.

Stress in women can be heralded by emotionality; altered appetite, sleep or sex drive; poor self care and low energy, motivation, self-esteem or confidence. Taking practical, supported steps in a timely manner will help address the problem.

How to manage stress

See your doctor: Ensure there are no serious medical symptoms that may be masquerading as signs of stress. If psychological, try not to worry about stigma and see a psychiatrist early.

Know triggers to stress: Knowing our responsiveness or adaptation style is the first step towards effective stress management. Try not to blame or judge yourself harshly. Focus on building your self-worth and independence with awareness, time and practice. Practice self-reliance, build a tool box of coping strategies and a good support network with the help of a professional or a supportive friend.

Work to live, not live to work: A consistent, regulated pace of work and life helps. Take brief breaks during the day. Leave work on time. If you are working from home, have a designated workspace, with time and space boundaries. Slot relaxation into your daily schedule.

Stay active and organised: Daily walks increase cardiovascular fitness
and release serotonin, the feel-good chemical that reduces anxiety and improves your mood. Planning ahead and sleeping on time can reduce anticipatory stress.

Be creative: Healthcare studies show that music and art in personal lives or the environment promote mental health and recovery from illness. Creative arts can reduce the impact of illness or pain. Research suggests that a combination of music and well-evidenced therapeutic techniques may be a useful adjunct for anxiety, depression, adjustment and emotionality.

Share and give: Connective, sharing experiences release the hormone
oxytocin. Community work is great for socialisation, confidence, self-worth
and timely support. Everyone’s upbringing and environment is different. Generalisations are not helpful. Simplifying your life and strengthening your mind can contribute to enduring benefits on mind and body, quality of life and satisfaction.

(The author is a senior consultant psychiatrist and medical educator, National Health Service, UK)